KARAKTERISTIK TERAPI DAN ANALISIS BIAYA PENYAKIT STROKE PERDARAHAN DI RUMAH SAKIT BETHESDA YOGYAKARTA

IRFANIANTA ARIF S, Dr. Tri Murti Andayani, Sp.FRS., Apt., Dr. dr. Rizaldy T. Pinzon, Sp.S., M.Kes.

2016 | Tesis | S2 Ilmu Farmasi

Stroke perdarahan merupakan gangguan fungsi sistem saraf yang membutuhkan biaya perawatan dan manajemen klinis jangka panjang. Cost of illness merupakan studi farmakoekonomi yang digunakan untuk mengukur beban ekonomi suatu penyakit. Penelitian ini bertujuan untuk mengetahui pengaruh cara bayar terhadap karakteristik terapi, mengetahui pengaruh karakteristik pasien terhadap total biaya penyakit,mengetahui komponen, rata-rata, dan total biaya penyakit,serta mengetahui perbedaan antara biaya riil dengan tarif paket INA-CBGs 2014penyakit stroke perdarahan. Jenis penelitian ini adalah analitik non-eksperimental dengan rancangan cross sectional study danpengambilan data secara retrospektif. Subjek penelitian adalah seluruh pasien stroke perdarahanRS Bethesda Yogyakartaperiode Oktober 2014-September 2015.Biaya yang diperhitungkan adalah biaya medik langsung dengan pendekatan bottom upberdasarkan perspektif rumah sakit. Analisis datamenggunakan ujinon parametrik, regresi linier, dan uji t. Hasil penelitian diperoleh 69 pasien rawat inap dan 52 pasien rawat jalan. Tidak terdapat perbedaan karakteristik terapi stroke perdarahan pasien rawat inap dan terdapat perbedaan karakteristik terapi stroke perdarahan pasien rawat jalanberdasarkan cara bayar.Kelas dan lama rawat inapberpengaruh terhadap total biaya riil rawat inap (p<0,05).Total biaya penyakit stroke perdarahan dengan cara bayar fee for serviceRp. 643.783.379,40,-dan prospective payment systemRp. 349.124.905,40,-.Komponen biaya terbesar pasien stroke rawat inap fee for serviceadalah biaya obat dan barang medikdanprospective payment systemadalah biaya kamar. Komponen biaya terbesar pasien stroke rawat jalan fee for servicedan prospective payment systemadalah biaya obat dan barang medik. Tidak terdapatperbedaan signifikan rata-rata total biaya penyakit stroke perdarahan pasien rawat inapdanterdapatperbedaan signifikan rawat jalan berdasarkan cara bayar (p<0,05).Terdapat perbedaan antara total biaya riil penyakit stroke perdarahan berdasarkan perspektif RS Bethesda Yogyakarta dengan total tarif paket INA-CBGs 2014. Total tarif paket INA-CBGs 2014 lebih rendah dibandingkan dengan total biaya riil penyakit stroke perdarahan berdasarkan perspektif RS Bethesda Yogyakarta.

Hemorrhagic stroke is a disorder of the nervous system functions that require maintenance cost and long-term clinical management. Cost of illness is pharmacoeconomics study used to measure the economic burden of illness. This study aims to know the effect of payment method to the therapeutic characteristics, determine the effect of patient characteristics to the total cost of illness, identifying components, average and total cost of illness,as well as knowing the difference between the real cost to the INA-CBGs 2014 package rates in patients with hemorrhagic stroke. This study is a non-experimental analytic with cross sectional study, using retrospectively data. The research subjects are patientswith hemorrhagic strokeperiod October 2014-September 2015 who met the inclusion criteria of this study. Costs that are taken into account are the direct medical costs with a bottom up approachbased on the perspective of the hospital. Analysis datausingnon-parametric test, linear regression, and t test. The research results were obtained 69 inpatients and 52 outpatients. No differences in the characteristics of hemorrhagic stroke therapy inpatients and there are differences in the characteristics of hemorrhagic stroke therapy outpatients by payment method. Payment method had aneffecton the real cost of outpatient (p<0,05). Class of hospitalization and length of stay have an effect on the total real cost of inpatients (p<0,05). Total cost of hemorrhagic stroke disease based on payment method fee for service Rp. 643,783,379.40,- and prospective payment systemRp. 349,124,905.40,-.The largest cost component of inpatients stroke with fee for service is the cost of medicines and medical goods and prospective payment system is the cost of room. The largest cost component of outpatients stroke with fee for service and prospective payment is the cost of medicines and medical goods.There is no significant differences in average total cost of inpatients and there is significant difference (p<0,05) in average total cost of outpatients hemorrhagic stroke based on payment method. There is a difference between total real cost hemorrhagic stroke disease based on Bethesda hospital Yogyakarta perspective with a total package rate INA-CBGs 2014. Total package rate INA-CBGs 2014 is lower than total real cost hemorrhagic stroke disease based on Bethesda hospital Yogyakarta perspective.

Kata Kunci : Karakteristik terapi, biaya penyakit, stroke perdarahan